To ensure universal and accessible healthcare services, the Health Sector Reform Commission has recommended forming an administratively autonomous Bangladesh Health Service (BHS) by restructuring the existing health cadre to establish professionalism, efficiency, and accountability.
The commission believes service delivery should be managed in an integrated manner through partnerships with relevant sectors and active involvement of public representatives.
It claims this reform can be achieved during the interim government’s tenure through the issuance of an ordinance.
On Monday, the Health Sector Reform Commission submitted its report to Chief Adviser Dr Muhammad Yunus at the state guesthouse, Jamuna.
According to the report, the existing health and associated cadres should be restructured to create a professional, efficient, and accountable administrative framework.
This framework would be led by an independent secretariat headed by a senior physician holding the rank of chief secretary.
The proposed Bangladesh Health Service would cover three key domains—clinical services, public health, and medical education—administered by designated deputy chiefs and directors general.
At the divisional level, 11 Regional Health Authorities would be established.
Health reform commission submits report to CAServices at the division, district, and upazila levels would be decentralized and granted financial and administrative autonomy to ensure effective, demand-based local service delivery.
As part of the reform, departments such as Family Planning, Health Economics, Nursing, the Tobacco Control Directorate, the National Electro-Medical Equipment Maintenance Workshop and Training Center (NIMU & TC), and the Transport and Equipment Maintenance Organization (TEMO) would be integrated into the Directorate General of Health Services.
Their services would be merged into relevant departments of the proposed Bangladesh Health Services.
The report further recommends transforming the Bangladesh Civil Service (Health) Cadre into an independent and autonomous cadre—similar in status to the Judicial Cadre—under the name Bangladesh Health Services.
All current officials would have the option to voluntarily transition to the new cadre.
Officers in the Bangladesh Civil Service (Family Planning-General) would be integrated into the proposed new cadre of the Public Administration Reform Commission based on qualifications, skills, and performance, with alternative options provided.
Field-level staff would be incorporated into relevant departments of the proposed Health Directorate, also based on education, competence, and performance, with an opt-out option available.
The report recommends establishing primary health centers in both rural and urban areas, along with the recruitment of primary care physicians.
In rural areas, union health sub-centers and family welfare centers would be merged, while in urban areas, ward-based centers would be established as the first tier of healthcare delivery.
A structured and, where applicable, mandatory referral system would be introduced to ensure patients receive appropriate care at the proper level and to reduce overcrowding in tertiary institutions.
Additionally, the report stresses the need for transparency in the recruitment process.
It recommends forming a high-level search committee to oversee recruitment and nominations based on merit, transparency, and political neutrality.
Parliament must be informed of the qualifications of individuals appointed to key positions such as the Head and Deputy Heads of Bangladesh Health Services, directors general, vice-chancellors and pro-vice-chancellors of medical universities, treasurers, principals of medical colleges, and chairpersons of BMDC and BMRC.
The commission also recommends establishing a separate Public Service Commission (Health) to independently oversee appointments in the sector.
